Healthcare in Spain is free for those that contribute to social security. I have read that users sometimes need to pay 25% of the cost of medical treatment but have not experienced this in practice. By law, medical emergencies are treated without regard to patient's insurance. Prescription medicine is cheap (in my opinion, compared to the USA).
Hmmm... I wonder if these factors have anything to do with the reason I see so many healthy and active senior citizens walking the streets of Barcelona? Seriously. I see people so old here walking to the market with their shopping carros. It always shocks me a bit because I bet that most of their peers in the United States are half as active. Just check out these stats from the World Health Organization. Compared to the United States, the people of Spain have a longer life expectancy along with a longer healthy life expectancy, a lower probability of dying under 5 and between 15 and 60 years old. And to top it off, Spain spends far less on health as part of the GDP and per capita compared to the USA.
:: Public and Private Competition ::
The public healthcare system competes with private systems of insurance and doctors. If you don't want to use a public doctor, you can visit a private medical practice and pay out of pocket or use coverage from private insurance. Allianz, AXA and Cigna are several of many choices for private insurance. Since there is so much to write about the systems and our experiences, I will write a separate post on private healthcare in Spain.
:: Our First Experience with Public Healthcare ::
A couple months ago, both of my children (ages 4 and 6) were sick. At 4 pm, one Thursday afternoon, I decided to take them to the doctor without an appointment. Not even a "we're on the way in" phone call. I took them to the public clinic for our neighborhood, which is only 4 minutes away from home. We didn't have our CatSalut cards yet.* The receptionist asked if we lived here and took our passport information instead. She also checked our local empadronamiento papers. She handed us a checklist for us to get our CatSalut cards and directed us to the pediatric waiting room.
There were a couple areas of chairs along with a climbing structure and children-sized table and chairs. There were about six pediatricians offices. About five other moms were waiting with sick kids. It took about five minutes for a pediatrician to open his office door and call our names. Yes, that was 5 minutes! Inside, the office was clean, well-equipped and spacious with a few child-friendly touches. The doctor talked to us before examining the children. He was very knowledgeable, understanding and helpful. He didn't even blink twice that we are obviously foreigners (well, my husband is not so obvious, but amongst ourselves we were speaking English in front of him). We left the doctor before 5 pm. That was in and out in one hour with exceptional service.
And when we left, we just walked out the front door. No papers to sign. No copays to pay. Nothing. Except for a friendly wave from the receptionist that helped us. I was in disbelief. I was shocked. I felt like I had been lied to about socialized medicine. As much as I have been an proponent for universal access to quality healthcare, I think in the back of my mind, those media-sponsored images of sub-par care lurked in mind. (Even though I received great care with the National Health Services when I lived in London.) I was blown away. I have even thought of taking all my out-of-town visitors from the United States for a visit to the public doctor. Could you imagine waltzing into a US doctor's office without insurance and seeing the doctor within five minutes? Could you imagine only waiting five minutes for your US doctor when you have an appointment and insurance?
* We still don't have our CatSalut cards. Only because we haven't started the paperwork to receive the card as EU citizens and Spanish residents (involves a visit to a government office with some documents).
On a side note: Catalunya is an autonomous region of Spain. I am not sure how much the government-run programs here differ from other areas of Spain. Also, this is not meant to be a complete, in-depth look at the public healthcare system in Spain. Rather, our experience in using a system different from where we lived in the United States. Others can explain the ins and outs of the Spanish healthcare system far better than me.
:: More Information on Spanish Healthcare System ::
- Spanish Healthcare System by SpainExpat
- Expatica's Guide to the Spanish Healthcare System
- Spanish Healthcare Explained by UK Guardian Weekly
- Social Security and Healthcare in Spain by AngloInfo